Vascular and Endovascular Surgery Unit - Department of Emergency and Organs Transplantation, "Aldo Moro" University of Bari School of Medicine, Bari, Italy.
Vascular and Endovascular Surgery Unit - Department of Emergency and Organs Transplantation, "Aldo Moro" University of Bari School of Medicine, Bari, Italy.
Ann Vasc Surg. 2021 Apr;72:667.e11-667.e16. doi: 10.1016/j.avsg.2020.10.040. Epub 2020 Dec 14.
A 54-year-old male patient was admitted with acute left lower limb ischemia (ALI). Computed tomography (CT) angiogram showed an isolated abdominal aortic dissection (IAAD) with a single entry tear just proximal to the aortic bifurcation and an intramural hematoma (IMH) extending to the descending thoracic aorta. The IAAD involved the left iliac bifurcation, with a flow limiting dissection flap into the internal iliac artery (IIA) and external iliac artery (EIA) thrombosis with femoro-popliteal embolization. A surgical thrombectomy of the femoral arteries was performed. An unibody bifurcated endograft was deployed into the true lumen to cover the entry tear, and a double-barrel technique was employed to restore the flow into the EIA and to preserve the IIA patency. The postoperative period was complicated by a compartment syndrome of the calf, requiring a fasciotomy. Follow-up imaging after 12 months showed complete resolution of the IAAD and patency of the stented vessels.
一位 54 岁男性患者因急性左下肢缺血（ALI）入院。计算机断层扫描（CT）血管造影显示孤立性腹主动脉夹层（IAAD），在主动脉分叉近端仅有一处入口撕裂，壁内血肿（IMH）延伸至降胸主动脉。IAAD 累及左侧髂总动脉分叉，夹层瓣片流入髂内动脉（IIA）和髂外动脉（EIA）导致血栓形成并伴有股腘动脉栓塞。行股动脉取栓术。将一体式分叉型覆膜支架植入真腔以覆盖入口撕裂处，并采用双腔技术恢复 EIA 和 IIA 的血流通畅性。术后出现小腿间隔综合征，需要行筋膜切开减压术。12 个月后的随访影像学检查显示 IAAD 完全缓解，支架血管通畅。
